Frailty Index May Predict Outcomes in Older Patients

A deficit-accumulation frailty index constructed from a comprehensive geriatric assessment may predict outcomes in older patients with cancer, according to a study published in the journal Cancer.1

Because frailty has been suggested as a domain for clinicians to consider when treating older patients with cancer, researchers sought to evaluate a frailty index from a mostly self-administered comprehensive geriatric assessment.

For the study, 500 patients age 65 years and older underwent the geriatric assessment prior to the receipt of chemotherapy. Investigators constructed the 51-item frailty index, and then examined cutoff values for patients in the robust/nonfrail (cutoff value, 0.0 to less than 0.2), prefrail (cutoff value, 0.2 to less than 0.35), and frail (cutoff value, 0.35 or greater) groups.

Of those evaluated, 50% were considered were nonfrail, 39% were prefrail, and 11% were frail. Researchers found that older age (80 years or older), lower education, living alone, and higher stage of disease were associated with prefrail/frail status.

Results showed that prefrail/frail patients were more likely to experience grade 3 or worse toxicities but not to require dose interruption or reduction. They also had a higher likelihood of drug discontinuation and hospitalization.

"The frailty status so determined is associated both with outcomes likely because of chemotherapy toxicity and with those likely because of age-related physiologic and functional deficits and thus can be useful in the overall assessment of the patient," the authors concluded.